I always end my sessions by asking my clients, “Based on what we discussed today, what are you going to work on for homework?” At the end of a recent session with a client who has the tendency to avoid her feelings and thoughts of her past trauma, when I asked this question, she responded, “Dr. B I am going to work on feeling my feelings and making friends with them.” I could not be happier! She got it. She was trying so hard to push the feelings away that it was exhausting her. We worked on the idea of thinking of her symptoms not as something that had to be pushed away, and gotten rid of, but as a part of her that needed to be reintegrated.
In his book The Body Keeps The Score: Brain, mind and body in the healing of trauma, Bessel Van Der Kolk, M.D. talks about “Befriending the Emotional Brain.” Since I am not going to go into the specific treatments for PTSD, as it can vary from person to person, I want to summarize what Van Der Kolk shares as a place for you to start in terms of beginning the journey of recovery from trauma.
Dealing with Hyperarousal
The vagus nerve connects the brain with many of the internal organs. Eighty percent of the fibers of the vagus nerve run from the body to the brain. This gives us the ability to influence our arousal via our breath, movements, and vocalizations. Being able to use the breathe to achieve a state of physical relaxation while visiting painful memories is required in order to recover from traumatic experiences. Taking a few deep breathes you can notice the parasympathetic nervous system damper your arousal. The more you focus on your exhale until the very end and then pause before your inhale the more you will turn on your parasympathetic nervous system. Continue to breath and notice the air moving in and out of your lungs thinking about how the oxygen nourishes and energizes the cells of your body helping you feel connected and alive.
Self-awareness is at the center of recovery. Being able to notice our irritation or anxiety allows us to change our point of view and see other options besides our usual habitual reactions. Mindfulness allows us to see the transitory nature of our feelings and perceptions. When we tune in with focused attention to our bodily sensations we can feel the ebb and flow of our emotions and with that we can increase our ability to have control over them. The first task is focusing your mind on your sensations and noticing how the sensations are transient and shift in response to changes in body position, breathing, and thinking. Next start to label what is happening, i.e. “When I feel sad I feel a prickly knot in my stomach.” Focus on the sensation and notice how it changes when you take a deep breath and focus on the exhale, or allow yourself to cry. Being self-aware, or practicing mindfulness calms down the sympathetic nervous system so that you are less likely to be catapulted into fight or flight. Gaining the skill of observing and tolerating physical sensations is essential for safely revisiting the traumatic memories. Mindfulness decreases activity of the amygdala and thus decreases reactivity to potential triggers.
Repeated research studies have shown that having a good support system is the single most powerful protection against developing PTSD. Our brains are wired to be in-tune with others. Remember those mirror neurons?? Recovery involves connecting with others. When trauma occurs within trusted relationships it can be more difficult to treat due to the fear of being re-traumatized within a relationship. This can take a toll on other relationships as the fear of getting hurt can prevent the formation of the required healing relationships.
Communal Rhythms and Synchrony
When we are able to play with others we feel attuned and experience a sense of connection and joy. Drum circles are a wonderful example of this feeling in tune with and connected to others.
Getting in Touch
The most natural way we as humans are soothed is by being hugged, touched, or rocked. Think of an infant, how we rock, and hold them in order to sooth their distress. This desire to be held and comforted in times of stress stays with us forever as a means of helping us calm.
The purpose of stress hormones are to give us strength and endurance so that we can respond and act in traumatic situations. People who take action during a traumatic situation use their stress hormones for their proper purpose and thus are less likely to develop PTSD. Feelings of helplessness and not being able to take action prevent the use of the stress hormones as they are meant to be used. This results in the stress hormones and activation that was meant to fuel coping with the stress, to be turned back against the organism. This results in the continuing of misplaced fight, flight, or freeze responses. When these responses to extreme stress get stuck, treatment moves to explore physical sensations and identifying the location and shape of how the trauma left its mark on the body.
As mentioned in a previous post, Peter Levine developed Somatic Experiencing which focuses on guiding clients in gently moving in and out of feeling the imprints of the traumatic memory left on the body in a process he calls pendulation. Moving in and out of the traumatic sensations helps clients build their tolerance to such sensations. As clients become more aware and build tolerance to their trauma based sensations they are likely to recognize physical energy such as hitting, running or pushing that they wanted to do during the trauma but were unable to in order to maintain their safety. These impulses come out in subtle bodily movements.
Working to fully feel and express these movements in different ways can help bring the trauma to a close. Somatic Experiencing helps the client free themselves from the trauma by feeling that it is safe to move in the present. They literally move to free that pent up energy that got stuck during the trauma. In a training on Somatic Experiencing that I completed, Peter Levine treated a man who, as an infant, was in a holocaust orphanage. Peter Levine helped the client lean into his sensations and exaggerate what his body wanted to do. He ended up making these grand movements as if he was flapping his wings flying away. Just incredibly interesting stuff. The desire of the body to escape being acted out and released years later. In Somatic experiencing when the clients can feel what it would of felt like to take effective action, it can give them a sense of control. When clients can experience what it would of been like to expel that energy and fight or flee, their bodies can begin to relax and feel at peace.
So this is where I am going to end my blog series on PTSD. I hope it gave you enough information and understanding of what PTSD is, what it looks like, and how it impacts the brain and body. Like I said when I started this topic, trauma is a broad, heavy topic but one I felt compelled to address as so many people are not living fully due to their PTSD. I hope this information gives you a place to start if you or someone you love is suffering from PTSD. With great care and compassion. Until next time… Dr. B
Heck, S. (2013). Healthing and Resilience After Trauma. Home Study. heiselandassoc.com.
Levine, P. (2015). Peter Levine Ph.D. on Trauma: How the body releases trauma and restores
goodness. Online Training. catalog.pesi.com
Van Der Kolk, B. (2014). The Body Keeps the Score: Brain, mind, and body in the healing of
trauma. New York, NY: Penguin Books.